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Plantar Medial Avulsion Fragment Associated With Tongue-Type Calcaneus Fractures
Mark R Adams1, Kenneth L Koury2, Jaydev B Mistry3
11 Department of Orthopaedics, Rutgers-New Jersey Medical School, Newark, NJ, USA.
Foot & Ankle International
|March 8, 2019
Summary
Tongue-type calcaneal fractures are significantly more likely to involve a plantar medial avulsion (PMA) fracture fragment compared to joint depression fractures. This finding may impact treatment strategies for calcaneal fractures.
Area of Science:
- Orthopedic surgery
- Traumatology
- Radiology
Background:
- The plantar fascia attaches to the calcaneus, potentially causing a plantar medial avulsion (PMA) fracture fragment.
- This study investigates the association between calcaneal fracture types and PMA fractures.
Purpose of the Study:
- To determine if tongue-type calcaneal fractures are more frequently associated with PMA fractures than joint depression fractures.
Main Methods:
- Retrospective review of 271 calcaneal fractures across two Level I trauma centers.
- Classification of fractures using Essex-Lopresti and OTA systems.
- Radiographic assessment for the presence of PMA fracture fragments.
Main Results:
- Plantar medial avulsion fractures were present in 38.4% of all calcaneal fractures reviewed.
- PMA fractures were significantly more common in tongue-type (73.6%) compared to joint depression (8.2%) fractures.
- A statistically significant difference (P < .001) was observed between fracture types.
Conclusions:
- Tongue-type fractures show a much higher incidence of associated plantar medial avulsion fractures.
- Identifying PMA fragments may have clinical implications for managing calcaneal fractures.
- Further research is needed to explore the treatment implications of PMA fractures.
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